An aim of modern medicine is to provide personalized or individualized treatment regimens. Those are treatment regimens which take into account a patient's individual needs or risks. Personalized or individual treatment regimens shall be even taken into account for measures where it is required to decide on potential treatment regimens.
Heart failure (HF) is a major and growing public health problem. It is estimated that approximately 5 million patients in the USA have HF, more than 500 000 patients are diagnosed with HF for the first time each year, and more than 250,000 patients in the US die each year of HF as a primary cause. Heart failure (HF) is one of the main causes of morbidity and mortality in developed countries. Because of aging of the population and greater longevity of patients with cardiovascular disease incidence and prevalence of HF are increasing.
Heart failure may be symptomatic or asymptomatic. It is known some subjects with asymptomatic heart failure progress more rapidly to chronic heart failure, and thus are at elevated risk of hospitalization due to heart failure and/or death (Neeland et al., Journal of the American College of Cardiology Vol. 61, No. 2, 2013). It is important to identify these subjects as early as possible since this would allow for therapeutic measures that prevent or delay the progression to chronic heart failure. The identification of rapid disease progressors and appropriate therapeutic intervention is a, however, major unmet medical need (Neeland et al.).
Neeland et al. determines of cardiac markers in patients with left ventricular hypertrophy. Based on the determination of cardiac markers, a high risk group in the general population can be identified.
WO 2014/040759 discloses that cardiac markers such as NT-proBNP and a cardiac Troponin can used for the identification of subjects who should be subjected to an imaging based diagnostic assessment.
Zapolski et al. describe the association of abnormal MFS (Midwall fractinonal shortening) and elevated levels of NTproBNP in a cross-sectional study performed in hemodialyzed patients. The investigated patients are severely ill (Zapolski et al., BMC Cardiovasc Disord. 2012, 12:100).
Satyan et al. provide data of elevated NTproBNP in combination with abnormal MFS for the identification of the mortality risk in hemodialysis patients (Satyan S, Light R P, Agarwal R Am J Kidney Dis. 2007 December; 50(6):1009-19).
Masson et al. investigate the combination of several circulating biomarkers such as NT-proBNP with abnormal midwall fractional shortening (Circulation. Nov. 25, 2014; 130: A12358 Abstract 12358: Abnormal Left Ventricular Midwall Fractional Shortening and Elevated Circulating Biomarkers Predict High Mortality in Elderly Individuals in the General Population).